Salanova V, Morris H H, Van Ness P, Kotagal P, Wyllie E, Lüders H
Section of Epilepsy and Sleep Disorders, Cleveland Clinic Foundation, Ohio.
Epilepsia. 1995 Jan;36(1):16-24. doi: 10.1111/j.1528-1157.1995.tb01659.x.
To define further the electroclinical manifestations of frontal lobe epilepsy (FLE), we studied 150 seizures manifested by 24 patients; 18 patients had subdural electrode arrays (SEA). The findings in these patients clearly overlapped presumably reflecting the interconnections between functionally related frontal zones; yet the manner in which the symptoms clustered and the sequence in which they occurred generally indicated the anatomic site of the epileptogenic zone. We divided the patients into three major groups: (a) those with supplementary motor seizures, (b) those with focal motor seizures, and (c) those with complex partial seizures (CPS, psychomotor seizures). Supplementary motor seizures began with tonic posturing of the extremities. Focal motor seizures generally began with conscious contralateral version or unilateral clonic focal motor activity; tonic posturing was noted only late in the seizure. CPS (psychomotor) began with unresponsiveness at onset, followed by staring or unconscious contraversion. We compared frontal lobe seizures with temporal lobe seizures reported previously; oral-alimentary automatisms, repetitive hand movements, or looking around, were more common in temporal lobe seizures, whereas tonic posturing and bicycling movements were more common in frontal lobe psychomotor seizures.
为了进一步明确额叶癫痫（FLE）的电临床特征，我们研究了24例患者表现出的150次发作；18例患者有硬膜下电极阵列（SEA）。这些患者的发现明显重叠，大概反映了功能相关额叶区域之间的相互联系；然而，症状聚集的方式及其出现的顺序通常表明了致痫区的解剖位置。我们将患者分为三大组：（a）辅助运动性发作患者，（b）局灶性运动性发作患者，（c）复杂部分性发作（CPS，精神运动性发作）患者。辅助运动性发作始于肢体的强直性姿势。局灶性运动性发作通常始于有意识的对侧扭转或单侧阵挛性局灶性运动活动；强直性姿势仅在发作后期出现。CPS（精神运动性）发作开始时无反应，随后出现凝视或无意识的对侧扭转。我们将额叶癫痫与先前报道的颞叶癫痫进行了比较；口-消化道自动症、重复性手部动作或四处张望在颞叶癫痫中更常见，而强直性姿势和蹬自行车动作在额叶精神运动性发作中更常见。
